Provider Demographics
NPI:1811131683
Name:MORENO, LORRIE (RD/LD)
Entity type:Individual
Prefix:
First Name:LORRIE
Middle Name:
Last Name:MORENO
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12209 CIMARRON VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-4411
Mailing Address - Country:US
Mailing Address - Phone:713-447-8887
Mailing Address - Fax:
Practice Address - Street 1:12209 CIMARRON VALLEY LN
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4411
Practice Address - Country:US
Practice Address - Phone:713-447-8887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX896365133VN1005X, 133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal